Requena L, Sarasa J L, Piqué E, Fariña M C, Olivares M, Martín L
Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
Am J Dermatopathol. 1997 Oct;19(5):540-4. doi: 10.1097/00000372-199710000-00110.
The relationship between clear-cell syringoma and diabetes mellitus is well established. We present a case of clear-cell porocarcinoma in a diabetic patient. The lesion consisted of a 5-cm nodule on the lateral aspect of the left leg. Histopathologically, the neoplasm was composed of irregular aggregations of neoplastic cells with striking clear-cell appearance, showing features of ductal differentiation. The clear-cell appearance of neoplastic cells was due to glycogen accumulation within their cytoplasm. Immunohistochemistry and ultrastructural studies also supported the diagnosis of a neoplasm with sweat ductal differentiation. Enzyme histochemical reactions for phosphorylase immunoreactivity on fresh, unfixed sections of the neoplasm demonstrated that this immunoreactivity was remarkably decreased. Some adnexal neoplasms of the skin mostly composed of clear cells may be cutaneous markers of diabetes mellitus. Phosphorylase activity deficiency in diabetic patients may be responsible for glycogen accumulation in neoplastic cells resulting in clear-cell appearance of these neoplasms.
透明细胞汗腺腺瘤与糖尿病之间的关系已得到充分证实。我们报告一例糖尿病患者发生透明细胞汗孔癌的病例。病变为左腿外侧一个5厘米的结节。组织病理学上，肿瘤由具有显著透明细胞外观的肿瘤细胞不规则聚集组成，显示出导管分化的特征。肿瘤细胞的透明细胞外观是由于其细胞质内糖原积累所致。免疫组织化学和超微结构研究也支持了具有汗腺导管分化的肿瘤的诊断。对肿瘤新鲜、未固定切片进行的磷酸化酶免疫反应性酶组织化学反应表明，这种免疫反应性明显降低。一些主要由透明细胞组成的皮肤附属器肿瘤可能是糖尿病的皮肤标志物。糖尿病患者磷酸化酶活性缺乏可能是肿瘤细胞中糖原积累的原因，导致这些肿瘤出现透明细胞外观。
